Types of Arterial Disorders

Acute Arterial Occlusion

A thrombus (blood clot), embolism, or trauma can cause acute loss of blood flow to peripheral arteries. The most common location of an arterial embolus is at the femoral popliteal bifurcation, although an embolus can occur at other arterial bifurcations in the extremities. Crush injuries to the vessels of the extremities also can disrupt arterial blood flow and must be repaired quickly to restore circulation and prevent tissue necrosis. If a patient develops an acute arterial occlusion, immediate medical or surgical measures must be taken to maintain the viability of the limb. These measures could include complete bed rest, systemic anti-coagulation therapy, thromboembolectomy, or reconstructive arterial bypass surgery.

Arteriosclerosis Obliterans

Arteriosclerosis obliterans (ASO), also called chronic occlusive arterial disease, peripheral arterial occlusive disease, or atherosclerotic occlusive disease, accounts for 95% of all the arterial disorders affecting the lower extremities. It is a chronic disorder, most often seen in elderly patients. ASO is more common in men than women and is associated with risk factors that include elevated serum cholesterol (> 200 mg/dL), smoking, high systolic blood pressure, obesity, and diabetes.

ASO is characterized by chronic, progressive occlusion of the peripheral circulation, most often in the large and medium arteries of the lower extremities. It is caused by atherosclerotic plaque formation.

Thromboangiitis Obliterans (Buerger’s Disease)

Thromboangitis obliterans is a chronic disease seen predominantly in young male patients who smoke; it involves an inflammatory reaction of the arteries to nicotine. Initially, it becomes evident in the small arteries of the feet and hands and progresses proximally. It results in vasoconstriction, decreased arterial circulation to the extremities, ischemia, and eventual ulceration and necrosis of soft tissues. The inflammatory reaction and resulting signs and symptoms can be controlled if the patient stops smoking.

Raynaud’s Disease

Raynaud’s disease, also known as primary Raynaud’s syndrome, is a chronic, functional arterial disorder that occurs more often in women than men. Thought to be caused by an abnormality of the sympathetic nervous system, it is characterized by digital vasospasm, most often affecting the small arteries and arterioles of the fingers and sometimes the toes. Vasospasm is brought on by exposure to cold, vibration, or stress. The response is characterized by temporary pallor (blanching), then cyanosis and pain, followed by numbness and a cold sensation of the digits. Symptoms are relieved slowly by warmth.

When the disorder is primary, it is called idiopathic Raynaud’s disease or Raynaud’s syndrome. When it is a secondary complication and associated with another disease (such as scleroderma, systemic lupus erythematosus, systemic sclerosis, or vasculitis), it is called Raynaud’s phenomenon.

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